Estimates suggest that up to 50% of patients may not be taking their prescription drugs as prescribed all of the time. Reasons for nonadherence vary, with patients reporting fear of potential side effects, misunderstanding the need for the drug, and cost-sharing challenges due to the high price of prescription drugs set by Big Pharma as significant barriers. Nonadherence can lead to poorer health outcomes and even increased mortality, especially in patients with chronic diseases.

Johnny Garcia, pharmacist and Assistant VP, Policy, PCMA explains how nonadherence impacts health and the many ways that pharmacy benefit managers (PBMs) are innovating to promote medication adherence for patients:

PBMs are leaders in innovation and have launched programs that help address barriers to adherence and promote better health. Many of these programs are in response to the evolving market demand for more comprehensive services and stronger connections to patient health outcomes. For example, PBMs improve drug therapy and patient adherence in diabetes patients, helping to reduce thousands of hospital visits, heart attacks, strokes, etc., annually.

PBM programs on medication adherence include:

• Establishing medication therapy management (MTM) programs where PBM clinicians partner directly with local pharmacists, which target patients who are on multiple medications that benefit from improving the use of medications through personalized recommendations and support.
• Offering patient assistance programs to help remove cost barriers for patients, helping them afford their medications and reducing prescription abandonment rates.
• Recommending 90-day supply and automatic refill programs through retail and mail order to increase adherence.
• Providing individuals with specific chronic conditions personalized support including medication reviews, routine one-on-one discussions, and actionable recommendations to improve medication adherence and close gaps in care.
• Providing data, educational materials, and support to providers, pharmacists, and plan sponsors to help monitor abandonment rates – due to factors like cost, side effects, or drug shortages – that decreases access to medications. This may include providing real-time prescription benefit tools (RTBTs) to providers leveraging the latest technology.

These programs combine the advanced technology and analytics along with the clinical expertise of PBMs to provide medication adherence programs that help patients take their drugs safely and appropriately.

To learn more about how PBMs are innovating to put patients at the center, explore the PBM Innovation Project HERE.

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PCMA is the national association representing America’s pharmacy benefit companies. Pharmacy benefit companies are working every day to secure savings, enable better health outcomes, and support access to quality prescription drug coverage for more than 289 million patients.